Tuesday, January 29, 2013

The pain of thrush can rival that of labor. Burning sensations that radiate through the breast are accompanied by deep stabbing and shooting pains. What's more, the outward appearance of thrush varies widely, making diagnosis a problem. Some women have red or shiny nipples, fissures or flaking skin, others exhibit no visible signs at all. And diagnosis is only the start. Thrush is remarkably persistent and knowledge of the best treatments to cure breastfeeding-related thrush is sorely insufficient, as this week's triumphant mom found out.“I gave birth to my daughter Olivia at home. I really wanted to let her find the breast herself but I remember almost feeling like I needed permission from the midwives. When they finally told me it was time to try and nurse I chickened out of the natural 'breast crawl' approach. Instead, they had me sit up in bed and told me to use the cross hold.

Nipple DamageOlivia latched incorrectly immediately and I started to cry. I kept her on my breast and the midwives told me a bit of pain is normal but it should stop right away. Well, it didn't. After a few more minutes I took her off and the damage was done.Baby Weight IssuesThe next day, I had a lactation consultant come to ‘help’ me. She weighed Olivia and freaked out, telling me that she'd lost 13% of her weight and she should have only lost 7-10%. She then told me told me the insane amount of breastmilk I needed to feed Olivia: 50 ml at each feed, and in 2 days from then 75ml at each feed. I was totally shocked by this amount. It didn't make sense. She told me if Olivia wasn't gaining weight in the next few days I would need to supplement with formula. I told her that wasn't an option, thanked her for helping me with my latch and asked her to leave. My husband was downstairs when this happened. When he came upstairs I was bawling. He didn't believe those numbers either, so of course on the computer we went, only to see how wrong she was!

My midwife popped in that afternoon and was mad that this woman even weighed the baby. She reinforced the reason why they wait a full week before they re-weigh and that Olivia had great color (zero jaundice from birth) very alert for a newborn, no soft spot on the head and a wet mouth so she was in fact eating. I sent my fiance to get me a pump so I could try to pump and heal my nipple.RashWhen Olivia was 2 weeks old she developed a rash on her bum which turned out to be thrush. It had infected my breast was extremely painful. There was shooting pains from my breasts right up to my shoulder, even when I wasn't feeding. During the feeds my nipples felt like they were being cut with glass. We tried monistat, an antifungal treatment, on her bum which didn't work. I did a week of gentian violet along with it which also didn't work.Friends' SabotageI hadn't left the house in 2 weeks because my daughter’s mouth was stained violet and I kept her naked up to 5 hours a day to air out. I felt like the worst mother in the world; like I'd failed from the beginning. Friends told me to just give formula. I wasn't talking to them for a way out of breastfeeding, I was just trying to vent my frustration. Sharing these experiences with other moms is supposed to be helpful. I wasn't trying to make anyone feel bad about their choice but I just don't agree with formula for my family.Finally, a Cure

I finally found a doctor in Toronto - Jack Newman and followed his flucozanole treatment. It ended up taking me being on this drug for 37 days, continuing on a strict yeast free diet, probiotics, gentian violet and lots of air time before it went away. When Olivia turned 4 months old it was finally gone.Fighting this for 3.5 months was exhausting and truly tested my confidence as a new mother and my commitment to breastfeed. To this day I cannot feed in that damn cross hold. I can only nurse lying down.I believe that unless you're a drug user or have a lifestyle that could harm your baby every woman should breastfeed. I don't understand moms that stop because it was too much work to nurse every 2 hours. The thought of having to get out of bed and make a bottle instead of putting my baby to my boob seems like more work.”

Tuesday, January 22, 2013

There’s no such thing as nipple confusion. Bottle feeding is best because you know exactly how much your baby is consuming. It’s wise to introduce a bottle as soon as possible to ensure your baby won’t reject them. Premature babies, in particular, need bottles because they can’t suckle - These are some of the typical myths promulgated by our bottle-centric culture. This week’s triumphant mom fell casualty to these myths, yet clawed herself out of the bottle trap. This is her story:

“My pregnancy was normal until about 29 weeks. I had plans to have peaceful water birth at a local birthing center. Within 3 weeks, however, I developed high blood pressure which turned into severe pre-eclampsia and was hospitalized until I delivered. Being hospitalized for that long was quite scary and lonely. The days felt like they dragged on forever. When the protein in my urine reached a certain level, the doctor made the decision to operate.Born 8 Weeks Early

I had my daughter, Lucy, at 32 weeks. She was 4lb6oz and 16.75 inches long. I always knew that I wanted to breastfeed my baby. At first, I had no idea what the implications of an early delivery would mean for being able to nurse. A lactation consultant came by a few hours before I delivered and asked me if I intended to pump for my baby. I did, and pumped for the first time in recovery, after my c-section. I recorded every mL that I got when I pumped - it took ten whole days for my milk to come in! I was pumping every two hours around the clock! It was exhausting.Pumping with a PurposeAt first, pumping had some positive aspects. It made me feel like I was really *doing something* for Lucy, while she was in the hospital. It gave me a purpose. I rented a hospital grade pump, which I'm sure helped tremendously. I carried my pump parts back and forth to the hospital, and pumped while I was there. I got a hands free pumping bra brought to me when I was still in the hospital. That is the best invention ever!Encouraged to Bottle Feed

For the first two weeks, Lucy had to take my milk through a tube in her nose. When the doctor said she was mature enough to start taking her feeds orally, I was encouraged to bottle feed. In the NICU, they like to know exactly how much is being ingested - and they even weigh the dirty diapers to measure output! Breastfeeding wasn't encouraged because they wouldn't know down to the mL how much she ate. They were hyper-focused on quantifying everything that entered her body and left it. I was able to have Lucy nuzzle and lick my nipple as she was getting fed through her nose, but I was never encouraged to try a feeding with breastfeeding.Bottles were key to getting out of hospital faster. Lucy had to take all bottle feeds for 48 hours to go home. We wanted her home, so I resigned my breastfeeding aspirations for the time she was in there. My hope was that once we got out of the hospital we could learn to nurse. Nothing in my original birth plan had worked out, and I desperately wanted to breastfeed my baby.'Human Milk Fortifier'The hospital staff were using something to up the calorie content of my milk, called ‘human milk fortifier’. As Lucy moved closer to discharge though, they switched to a 22cal formula to replace the fortifier. I got pretty upset and called the head nurse to see what was going on. They told me I would need to fortify her milk to ensure proper weight gain once we left the hospital, and that the human milk fortifier wasn't available for purchase. (A lie, I found it on diapers.com). I stopped using the formula once we got home and she gained just fine.The Burden of PumpingIt was when Lucy arrived home from hospital that pumping slowly morphed into a burden. I would pray that Lucy would stay asleep so I could pump! I heard the whooshing noise of the pump all the time, and it was driving me crazy! I was attempting to nurse every couple days or so, and it wasn't going well. I continued pumping for 3 more months before finally seeing a lactation consultant. I didn't feel like I could keep it going for much longer with my sanity intact. The Gradual Switch

At first, we took a gradual approach to switching from bottle to breast. I started using a shield and only nursing once a day - in the morning when I was the most full. I cried many tears because at times I thought we would never breastfeed successfully. My husband was not breastfed, and while he was 100% supportive, I could tell he didn't really understand why it was so important to me.Sometimes the idea of exclusively breastfeeding was scary too - I had recorded every mL she ingested since she came home from the hospital, to make sure she was taking in enough ounces throughout the day. Not knowing exactly how much she was eating was a scary thought!The Cold-Turkey SwitchOne Friday, in early February, we had a ferocious snowstorm. I figured that we would be housebound for a few days, and that it was the perfect time to try to switch all together. We haven't looked back since that weekend. For the first few months afterward, we also went to a weekly breastfeeding support group run by the LC that we had seen, which also helped tremendously.

Lucy loves nursing, and I love nursing her! She is about to be 11 months and still nurses every couple hours during the day. I am so thankful that I didn't give up. I plan to nurse her until she decides she’s done!People who don’t try breastfeeding are ignorant, or lazy, or both! I'm happy that there is formula so their poor babies don't starve, but it's sad that people choose against the most natural thing in the world.”

Tuesday, January 15, 2013

4.2% of babies are tongue-tied. Those with the condition are 3 times as likely to be exclusively bottle fed at 1 week (Journal of the American Board of Family Medicine 2005). Is this any surprise when prevailing medical opinion is that tongue-tie 'will usually right itself' by the end of the baby's first year. If the baby still has a problem after that, a paediatric surgeon might consider a frenulotomy - a procedure that divides the frenulum from the base of the mouth. Others will not perform surgery unless the child develops speech problems and has not responded to speech therapy. By that time, the child will require a general anaesthetic for the procedure. Where does this leave nursing mothers and their barbed-wire gummed babies? (click HERE to read the story of a mom that had to fight for her baby's tongue tie to be taken seriously).

However, fortunately, some doctors believe in a more pro-active attitude. These pro-baby miracle-workers are few and far between; mothers must take initiative and hunt them out, as this mom did:

“I was confident that everything about breastfeeding would be fine. I was convinced that formula was for emergency purposes, knew the statistics, and ate up the facts on how breast is best. I felt it was important to have the continuity of providing for my child and not just cutting our connection with formula. I fed her and held her inside for 9 months, so what is another 6, 9, 12, 24? Plus after reading the ingredients list on a formula can and seeing the costs monetary and possibly heath-wise, it became extremely important to succeed.The PainAbout a week after the birth of my little sucker fish I was actually counting the days I had to go through to get to 6 months. It was so hard my nipples were turning white and blistering. Lanolin and other creams provided zero relief. My husband and mother in law suggested a pacifier since I was exhausted and in pain. Also, my daughter seemed ‘skinny’ to me. I grew up with a perception that infants were always chubby.Tongue-Tie ConfirmedAt Sophia’s weigh-in check, my deepest fears were confirmed - I found out that my baby had lost a lot of weight and had not gained her birth weight. She was also diagnosed with tongue tie and wasn't suckling properly. This was causing the pain and damage. It wasn’t until a week later that I managed to see the doctor who would perform the tongue-freeing procedure. So I suffered through the week, dreading each feeding and squeezing milk into my baby’s mouth using compressions (as I had read online via Jack Newman’s website) and pumping when I could nurse no more.

Due to the effort required for her to nurse Sophia’s legs would turn blue (that was super weird and scary); she started to develop very poor digestion and colic. We took her to the osteopath who works on babies and she was able to untwist her small intestines and tilt her stomach. On that visit Sophia burped out a ridiculous amount of air and shot poop all over that women. I was horrified! To which she smiled and said in French "cest bon sophia!" after that she would eat even longer, sleep longer and didn’t develop full on colic.SaboteursMy friends who saw my breasts said that they had this problem and stopped breastfeeding, and after formula their child is okay so not to worry. Another of my very assertive friends told me how to go about finding a proper formula for my daughter and that there was no shame in it (Her kid has eczema and would still not sleep well at 3, so this made me look ahead at what my baby ‘might’ get from it). My friend’s weren’t the only unhelpful voices. My aunts, whom all formula fed, told me that my child was too thin and breastfeeding for 6 months exclusively was cruel and starving her of nutrients. I walked down the aisle of the drug store and looked at every can of formula and felt lost in the words of ‘you can do it’ vs ‘formula is okay’.The SnipFinally it was time for the doctor’s appointment. We were slipped in after the working hours. In 30 seconds my baby had two snips to her frenulum and was latched back to my breast by the skilled hands of this miracle woman. The doctor watched my daughter feed then examined her tongue and swallowing once more, then waited as my skinny little baby fed for nearly 30 minutes both sides.

The days following were so hard. Even though she was latching properly and sucking efficiently, my breasts were painfully scabbed and damaged, and my confidence was shattered. I felt inadequate naturally. It took my daughter six weeks to gain her weight back and for my milk supply to really stabilize. Luckily my mother and midwife urged me to see a lactation consultant to verify that everything was going right.That hour of nursing and practice with the LC helped my confidence grow back. Dr Newman’s all purpose nipple ointment sealed my cuts and put me on the road to recovery (it was almost 2 months before the pain was completely gone). Google and Kellymom helped me find my way past blocked ducts and the low supply caused by the early lack of proper nursing and pumping, along with inappropriate pacifier usage. I took away the pacifier and nursed on demand. I literally set up camp and made myself the President of Nursing Inc. I feel like all I did was nurse and eat. After a little while I had tons of milk!!

There are so many hurdles to breastfeeding that will break you if you let them. I am so glad formula never made its way into my home despite the challenges. I feel grateful that I was able to breastfeed my beautiful little girl for 18 months after this ordeal. She is healthy, intelligent and rarely ever sick. I feel like I gave her the best start I could. My challenges gave me compassion and the drive to be a proactive woman. As a shower gift to my pregnant friends, I give them a coupon for an hour with a lactation consultant. I want everyone to have the proper help to be successful at breastfeeding.Most women struggle at breastfeeding, and women who succeed are often portrayed as lactivist, self righteous, and un-sympathetic. When a mom tells me why she is formula feeding, it is usually due to sabotage whether she realizes it or not.I don’t understand why online formula feeding forums even exist. How hard can it really be to fill and hold a bottle. I feel like saying, "you want to hear problems? I’ll send you a pictures of my spazzy nips ladies" but I let it slide.”

Monday, January 14, 2013

In recent years there has been a welcome cultural shift in the way our society (the scientific and medical communities at least) views breastfeeding. Research has re-established breastfeeding as the normative ideal for infant feeding, partly-facilitated by a boom in breastfeeding activism.

However this growing pro-baby culture has produced a particular breed of formula feeder – the ‘Defensive Formula Feeder’ (or ‘DFF’ for short). In this article I am going to outline the central characteristics of defensive formula feeders and how you can distinguish them from all other formula feeders.

Victim Mentality

DFFs are plagued with a victim mentality. They claim (and may even believe) that they had no control over the way that events unfolded leading to their breastfeeding failure. They use words like, “I had to use formula” and “I had no choice”. They spend their time looking outside of themselves to explain what happened or didn’t happen.

DFFs see any discussion of breastfeeding as an opportunity to recite their ever-lengthening list of reasons why they ‘couldn’t breastfeed’. How many times have you witnessed a perfectly civil breastfeeding conversation sabotaged by a formula feeder with the immortal words, “but not everyone can breastfeed”.

The internet is a dangerous place for DFFs. They have always to be prepared for the worst, as it is full of people who are out to hurt them. In their view, it is a harsh environment of victims, victimizers, and occasional rescuers.

The internet is also a place for DFFs to infect and assimilate. Like attracts like, so it only makes sense that defensive formula feeders attract people like them. When you’re in a social situation and everyone is complaining about why they ‘had’ to give up breastfeeding, it’s easy for even the most positive formula feeder to fall into the trap of victimhood.

Opaque Aggression

DFFs are passive-aggressive in their interactions with breastfeeders. The passive-aggressive style is often a very subtle and non-direct way of expressing anger without openly acknowledging it. DFFs seem superficially receptive to other’s suggestions, but are experts in passive resistance. For example, they may claim to have tried pumping their breast milk, but the reality is that they only tried for a day before giving up. During discussions, they can exaggerate how long they ‘tried’ for.

In the online environment, within minutes their behaviour will escalate. They will ascribe non-existent negative intentions to neutral statements,sulk, pout, withdraw, bungle, make excuses, and lie. Their talent at sending mixed messages catches others off-guard. One minute they’re having a civil conversation, then they’re offended, then they claim to enjoy the debate, then they are angry. Their behaviour appears very schizophrenic as they battle with their inner demons on the public stage of the internet forum or Facebook page. A common theatrical performance of a DFF is to post on a breastfeeding forum:

...rather than simply leaving. With these people, you can never truly know how your words will be received, which creates an egg-shells atmosphere, choking any dialogue.

This behaviour has a self-defeating, almost masochistic quality. It is as if DFFs welcome the process of getting hurt and are attracted to media which triggers them. They actively seek out breastfeeding forums, blogs and advocates. If they mistakenly stumble upon such a group, they do not leave. Instead they enjoy the masochistic buzz of being offended and arguing.

To compound the negativity of this outlook, DFFs know how to inflame others. They have a knack for dragging others into the emotional maelstrom they create, keeping them off-balance with their talent for shape-shifting. One moment they present themselves dramatically as victims; the next they are morphing into victimizers, hurting people with personal attacks and often reverting toGodwin's Law. As the internet is perceived as a dangerous place (particularly breastfeeding forums), DFFs strike out in a surreptitious way in order to defend themselves against the inevitable aggression of others.

They are also masters of manipulation, which can make interactions with them infuriating. It is almost as if they want people to exacerbate their guilt, only to prove subsequently, that they are being persecuted. Their talent for high drama draws people to them like moths to a flame. They gain short-term pleasure from feeling sorry for themselves or eliciting pity from others. Their permanent hurt feelings bring out altruistic motives in others. Which leads us to...

The White Knight (more of a hindrance than a help)

Where there’s a DFF, a White Knight is not far away. I’m sure you’ve witnessed this co-dependent romance yourself. A formula feeder cries offence and upset, and along comes a knight (usually claiming to be a breastfeeder, but you can bet your bottom dollar they’ve formula fed at some point) to defend their honour.

Another person’s suffering evokes strong natural responses of wanting to ease their suffering, to reassure, to defend. By defending, the White Knight satisfies their own desire for attention, drama and self-importance.

When online, DFFs are likely to exaggerate or dramatize their breastfeeding misfortunes, to make the need for rescue even more compelling. Unfortunately, satisfying this need does not bring a ‘cure’. Others’ sympathy is precisely the reason for remaining stuck in this defensive victim mentality. This is why so-called supportive environments don’t always work. When we’re told it’s okay to fail, and even have our emotional wounds licked by others, our failure is rewarded. Attention, sympathy and reassurance are prizes dealt to those who wallow in victimhood. Furthermore, the importance of the goal (successful breastfeeding) is diminished: “don’t feel bad, as long as your baby is fed somehow, that’s all that matters”. This sends the message to anyone reading that breastfeeding difficulties are not worth persevering through.

“Stop Making Me Feel Guilty” – The Sense of Entitlement

Part and parcel of being a DFF is a sense of entitlement. The formula feeder expects that all discussions on breastfeeding be out of bounds least they ‘hurt someone’s feelings’ (read: their feelings) or make someone ‘feel guilty’. This is particularly so when discussing the benefits of breastfeeding. These people also expect science to cease ‘wasting money’ on researching the fortitudes of breastfeeding. Instead the formula feeder will claim, “there’s much more important things to research, like war and poverty”. They believe that politicians, medical science, the media, and other mothers need to cease talking about breastfeeding’s natural superiority because it makes formula feeders feel bad. However in reality, nobody – no matter how hard they try – can ever make someone else feel something that they don't want to feel. You are the only one able to choose your feelings. Debate and progression should not cease because some people are offended by it.

Denouncing Breastfeeding Studies

Another strategy adopted by DFFs (normally those with more militant leanings) is to denounce breastfeeding studies. No matter how large scale the research or how reputable the research team, they will fabricate fault with it.

So for example, they will argue that the benefits of breastfeeding are exaggerated or non-existent, and therefore by formula feeding they have not put their child at any disadvantage. It is a form of denial, a face-saving technique. As social psychology puts it, “if the injury from the act is not as significant as first believed, the damage to the image of the accused should be limited as well” (Benoit. W). Click here to see a good example of denouncing in action.

Denouncing breastfeeding studies helps to justify the DFF’s use of formula, masking it as an ‘equal alternative’. Unlike excuse-making (covered here) in which the DFF admits that formula is sub-standard, but does not accept full responsibility for giving it; denouncers accept responsibility for giving formula but reject the claim that formula is sub-standard. A typical line might be, “I can’t see the difference between formula and breast milk, and I chose formula”. Some of these mothers are in denial, some do it to troll breastfeeding mothers, and some genuinely believe the two milks to be equivalent. This latter group suffer from the least guilt. They brush aside or reject factual statements, often contemptuously. "My child is 100% healthy so formula can't carry health risks".

Whatever strategy the DFF chooses to apply, each technique has one thing in common - insulting the intelligence of the listener. Playing the victim, excuse-making, manipulation, and denouncing, are all attempts to reshape another’s beliefs. It’s up to you whether you are taken in by it. I wrote about the array of DFF manipulation strategies in my book 'Breast Intentions'; in fact, I devoted an entire chapter to them, aptly titled 'Defensiveness'.

Next time you encounter a DFF, have a mental image of this bingo board, and see how many phrases you can spot. The board is particularly fun to use on internet forums, which are often populated by DFFs. Just use Microsoft Paint to circle the phrases as they come up in discussion. Popcorn optional.

Tuesday, January 8, 2013

Medical staff have a trigger happy tendency to push formula upon babies at the best of times. However, when confronted with a baby that doesn't fit the textbook norm, the drive to push formula is even more relentless. Rather than research or seeking specialist knowledge, medical staff who find themselves in this scenario often give half-hearted assistance and blind guesses before resorting to bottle-pushing, as this mother found out.“I always knew I'd breastfeed, formula wasn’t even considered. I did plenty of research on latching, I felt so prepared! Even so, our problems began right at the start of our journey. Hostile Hospital Staff

When Evelynn was born I noticed she had a flattened nose, making it hard for her to breathe and suckle at the same time. Consequently she kept pulling off. I asked the hospital staff to watch me nurse and they said the latch was great and that my daughter needed to eat right away. They said I wasn’t giving her enough. I insisted I wanted to go home but they kept me in for two nights. They told me over and over that my baby needed more food but didn’t do anything productive to help me feed her.After several more attempts I said I didn’t think she could breathe whilst she fed. They offered saline drops to clear her nose and told me to ring every time she wanted feeding. However as they were busy, every time Evie wanted feeding it meant I had to wait for them to arrive, then wait for them to go get the drops, then administer them, and in the meantime I had a screaming newborn! The drops didn’t even work though as her nose wasn’t ‘blocked’ - it was flat.

I also suspect Evie had a light lip-tie. When she was latched on I felt strange sensations and spasms on my right side, possibly vasospasm. The staff also kept bringing me more pillows so I could have her higher on my lap, which just squished her face more into my breast. The next day they said they needed to see her feeding chart before they would let me go home. This was the first mention of a chart I heard! I hadn’t kept one. A nurse said that she would need to give formula if I didn’t feed her. So in the end I dripped the colostrum straight into her mouth.

To confuse matters further, when Evie was asleep I asked if I should feed her. The nurse replied, “She’s asleep! Yes feed her when she wants, but no don’t wake her!” She looked at me like I was nuts. The next night, a student nurse sat with me while Evie fed for an hour. She kept assuring me that although it didn’t seem like Evie was sucking or swallowing (I couldn’t see movement or feel/hear sucking) while she was latched “she must have had something”. It was that feed which allowed me to leave the next day after being asked if I was confident breastfeeding. I wasn’t but I said yes just so I could go home and see my local breastfeeding team.Call in the ProsWhen I arrived home the breastfeeding team came round and showed me how to do the underarm hold which I found much easier. It kept Evie's nose completely clear so she could feed and my milk came in. However Evie still wasn’t eating much and my breasts became painfully engorged.I had to have the breastfeeding team round to my home a few times because Evie barely ate for 3 days. The health visitor was worried she'd loose too much weight and kept suggesting formula but the breastfeeding team encouraged me to keep at it.

One morning I phoned the team in tears. I was completely engorged after an awful night of being unable to latch Evie at all. They offered to come round right away asking me to hold on for an hour. I felt so relieved knowing I was getting help. This feeling is relief made me calm enough that just after the reassuring phone call I swaddled my screaming newborn and managed to latch her on! It still took some practise to get 'perfect' and after 2 years my toddler is a pro in all manner of positions!My Opinion Of People Who Don’t Try BreastfeedingPeople who don’t try breastfeeding fall into two groups.The first group are truly ignorant to the fact that breastfeeding is so much better then formula as well as cheaper and easier then bottles. These people I feel sorry for; that advertising and lack of understanding has robbed their child of breastmilk.

The second group are the ones who know about breastfeeding benefits, have researched it or learned about it at parent classes or even know breastfeeders; yet for whatever reason (parental pressure, society, embarrassment, disgust, perceived inconvenience) don’t even try to line their babies tummy with that liquid gold. To them I try to be understanding but ultimately I think they’re selfish. ”

Monday, January 7, 2013

Are some babies inherently good sleepers, while others aren’t? Yes to a certain extent this is true. However natural variations are a lot less than most parents think. There are specific patterns of sleep which are universal to most babies and toddlers. This timeline, collated through years of research, will outline these typical sleep patterns. It will explain what sleep behaviour you can reasonably expect of your little one at each stage of their development.

In Utero:

Nestled in the sleep-inducing womb, the environment is consistent and perfect for sleep. It’s dark, warm, quiet, and when you walk or move about, your baby is rocked to sleep.

Your baby is used to hearing the comforting sounds of your heartbeat, the gurgling of your stomach, and the soft tones of your voice. Also, he never experiences hunger due to being permanently hooked up to a steady stream of nutrition. As a consequence of these factors, your baby seldom has difficulty falling to sleep (Holland 2004).

Waking periods are random and for very short periods of time.

Your baby is a very active sleeper. The kicking and poking sensations that you can feel are often movements made during sleep (Pantley 2009).

By the seventh month of pregnancy your baby will start to dream as their brain is now developed enough to partake in REM (rapid eye movement) sleep (Murkoff 2009). In REM sleep, the higher centres of the brain receive stimulation from deeper, more primitive areas. Impulses come up the same sensory pathways that are used for sight and sound, and perhaps touch, smell and taste. This state may allow the unborn baby's developing brain to receive sensory input - to 'see' and to 'hear' - even before birth! (Ferber 2013).

During REM sleep, muscular impulses in the foetus are not blocked as completely as they are in children and adults, so the foetus has some ability to practice actual body movements.

By the eighth month of pregnancy your baby will also partake in non-REM sleep. In this more quiet phase of sleep, your baby makes no breathing motions. Yet if respiratory movements were never practiced, your child would be born with no experience at all in using these muscles that are so necessary to survival. Thankfully, respiratory motions do occur in REM sleep (Ferber 2013).

Children dream more the younger they are (Einon 2004). 90% of the sleep of premature babies is spent in REM sleep (Hames 1998). Unborn babies dream most of all. What does a foetus’ dream about? We can never know. Maybe just flashes of sounds and murky sights.

If you’ve had a 4D scan, you may have noticed your unborn baby ‘smiling’ in their sleep. This is because during REM sleep, facial muscles can twitch, producing ‘sleep grins’ (Sears 2009).

Your baby is ‘nocturnal’. He is most active during the night time as there is more room to move, and less soothing rocking motions to pacify him.

1 Day Old:

You’ve waited 9 long months to meet your baby, and now she’s here, all she seems to do is sleep. Newborns live up to the old adage of “sleeping like a baby”. Wakefulness in the first few hours after birth, followed by a long stretch, often up to 24 hours, of intermittent sleep, is the normal newborn pattern. You will still need to wake your baby for feeds every 3-4 hours whether breast or formula feeding.

At this point, the gestational age of your child would determine the sleep patterns or lack thereof. If your child was born early, use the EDD (expected date of delivery) as the true age to find out where your child might be within this timeline. So for example, if your baby was born 3 weeks early then at 1 month your baby would be 1 week old.

If your baby was born early he will probably sleep his way through the days until he comes to his due date, when he may suddenly wake up and you wonder what happened.

Your newborn is likely to fall asleep soon immediately after – and sometimes during – a feed.

Sleep is very erratic at this age and doesn't follow a pattern because basically the newborn's brain is still maturing. There is NOTHING a parent can do at this time to manipulate sleep. Don't force what is not possible.

If you watch your newborn while she is sleeping you will notice that there are times when, under her eyelids, her eyes flick frantically from side to side and she may frown, flutter suck, or wriggle her fingers and toes. This is REM or “dream” sleep. Unlike adults and older babies, newborns fall directly into REM sleep, a pattern that continues until they are around three months old.

Your baby will spend half of their sleeping time in REM sleep, whereas you (as an adult) spend only a quarter of your sleeping time in REM (Friedman and Saunders 2007).

Your newborn sleeps in cycles of around 50 or 60 minutes of REM (dream) and non-REM (deep) sleep. After each cycle your baby has a partial awakening – this brief moment of semi-awakeness may startle your baby and make him wake up even more (Holland 2004).

Towards the morning the proportions of non-REM and REM reverse, so that much of your baby’s early-morning sleep is REM (Sears 2009). This explains why babies often wake up more during that time.

It is recommended that your baby sleep in the same room as you for the first six months.

Your newborn may sleep for as little as 11 hours to 20 hours out of 24.

She may make sudden, jerky, twitchy movements in her sleep. This is due to a normal reflex called the “startle” or Moro reflex. It sometimes occurs for no apparent reason, although often it is a response to a loud noise or a sudden jolt. It may seem worrying to you, but the reflex is actually a reassuring sign that your baby’s neurological system is functioning well.

Almost undetectable breathing is also normal. In deep sleep your baby can breathe very quietly and look completely still.

A baby sleeping bag is a safer alternative to traditional sheets as your baby cannot wriggle under them; however, during these early newborn weeks it can be effective to use a sheet and blanket, as this helps your baby feel more secure when he is tucked in snugly. Then from 6-8 weeks you can change to using a sleeping bag as your baby develops more mobility.

2 Days Old:

“The sleeping habits of a newborn baby are perfectly logical and sensible – unless you’re not a newborn baby, in which case they’re completely and utterly insane” (Cooke 2009).

By the second night, newborns are often much more awake. However, some babies, especially those who had a difficult or traumatic birth, or preterm babies, may continue to be sleepy most of the time for longer than the first two or three days (Fredregill 2004).

Your baby will generally sleep between 16 and 19 hours a day. He will sleep for 2 to 4 hours, wake with a cry, feed, then be awake for 1 to 2 hours, and settle back to sleep (Friedman and Saunders 2007).

Your baby is unlikely to sleep any more during the night than he does in the day. That’s because newborns have yet to develop a functioning body clock so they have no concept of a difference between day and night (Smith 2010).

3 Days Old:

Though your newborn’s alert periods are initially very brief, they will gradually lengthen.

Your milk will come in around now, and your baby will use quite a bit of energy feeding; also breast milk has a soporific effect, so it’s very likely that he will drift back into contented sleep as soon as he’s had his fill.

During these early weeks your baby shouldn’t go for more than six hours between feeds at night and three hours between feeds during the day (La Leche League 2006), so wake her up if she has slept for this long.

It’s normal for your baby to become fussy in the evenings, normally around 6pm. This is due to over-stimulation - there’s a lot to take in when you’re new to the world. Ease your baby’s discomfort by making his evening environment, dark, quiet and comfortable.

When your newborn has had too much stimulation he will habituate. That means she goes into a state that looks like sleep but is actually just a way of shutting everything out. It’s a form of self-soothing that infants use until about six to eight weeks, when they begin to develop other ways with coping with stimulation (West 2010).

1 Week Old:

Your newborn sleeps an equal amount of time during the daytime (8 hours total) and nighttime (8 hours total).

Your baby requires food every few hours and this need is accommodated by his light sleep cycles.

If your baby is premature or has special needs, he is now likely to start waking more often at night. His sleep patterns will settle in time, but they will take longer than other babies (Johnson 2005; Pantley 2009).

There won’t be any semblance of a routine to your baby’s sleep at the moment and there’s little point in rigorously trying to introduce one.

The majority of your newborn’s time is spent sleeping and feeding. He will probably be alert only for short periods every day; he’s not mature enough to benefit from longer periods of alertness, and sleep (particularly REM sleep) helps him to mature.

2 Weeks Old:

By now, feeding will have become established, and hunger is likely to drive your baby’s sleep-wake cycles.

Around now, you will notice there is a particular time of day (or night) when your baby is almost always awake. For most babies this is the evening.

At this age your baby is likely to have their first growth spurt. During the growth spurt your baby may be restless, and her appetite will increase, especially during the night, prompting her to wake frequently for closely linked ‘cluster’ feedings. Growth spurts generally last 2-3 days, but for a few mothers they can last a week or so.

After the growth spurt you are likely to find that your baby has a period where she sleeps longer (Lampl 2011).

You may be tempted to introduce formula in the hope that it will help your baby to sleep through the night. However there is no reason to do this. Sleeping patterns vary from baby to baby, and the evidence on sleeping through the night shows no difference between breastfed and formula-fed babies (Rosen 2008; Quillin and Glenn 2006).

Another thing that may be keeping your baby awake is colic, which begins in some babies around now. About 20% of babies get colic, which can last for three months or longer (McLaughlin 2009).

If your baby is not gaining weight well by the end of the second week of life, she should be awakened every two to three hours and encouraged to feed more frequently.

At this age, most babies aren't able to stay up much longer than two hours at a time. If you wait longer than that to put your baby down, she may be overtired and have trouble falling asleep.

3 Weeks Old:

Your baby will need time to adjust to life outside the womb, and some crying and wakefulness in these early weeks is simply a result of feeling strange and confused.

These first few weeks of your baby’s life are naturally disorganized. Each day may be completely different from the previous one, and imposing a rigid sleeping pattern on your new baby will not work.

At this stage, most mothers survive on an average of three and a half hours’ sleep a night (McLaughlin 2009).

Your baby will now be more aware of her surroundings and won’t sleep quite as effortlessly as he did when he was newborn. He’ll need a bit more rocking and soothing than initially and he’ll also wake more easily if he hears a noise (Cave and Fertleman 2012).

1 Month Old:

Gradually your baby’s periods of wake -fulness have grown longer, so that by now she is alert for a few hours a day (Friedman and Saunders 2007; Holland 2004). In fact, the mean percentage of daytime sleep has decreased from 82.4% at Day 2 to 62.8% now at 1 month old (Huang et al 2009).

The average number of hours of sleep your baby currently needs in the daytime is 7 and in the nighttime is 9 (Hames 1998).

Don’t expect your baby to sleep through this night this soon. In fact, “if your newborn baby is sleeping through the night, this may not be normal” (Friedman and Saunders 2007). If your baby goes longer than four or five hours between feeds because she’s sleeping, this could be a sign of illness – she may lack the energy to wake and cry for feeds. Also if you’re breastfeeding, too few feeds in the first few weeks may mean your milk supply isn’t getting the stimulation needed to build up a really good supply (see, ‘Timeline of a Breastfed Baby’).

Nonetheless, your baby will sleep for longer periods than she did before, so that instead of one or two hours, she may be able to sleep for three or four.

6 Weeks Old:

Some believe that the earliest your baby will be physically capable of sleeping through the night without a feed is around now (Laurent 2009). Personally I believe the very earliest is 4 months (as does Cave and Fertleman 2012) partly because at 6 weeks...

Your baby’s second growth spurt will occur around this time prompting more night wakings.

After the growth spurt you are likely to find that your baby sleeps longer for a day or two (Lampl 2011).

The average 6 week old wakes 3 or 4 times per night (Galland et al 2012). This is a global norm.

It’s a myth that you need to get your baby on a strict schedule from the get go, and doing so may be dangerous because his body is not developmentally ready to wait several hours between feeds or sleep periods.

Not all babies have the ability to self-soothe at this age, so it’s important not to do any form of sleep training or ‘crying it out’. Also bear in mind that the ability of your baby to produce cortisol in response to stress is greatest during these first few months of life, thus sleep traing would keep them awake even longer (Larson 1998).

Take advantage of your baby’s portability at this age. Many babies like to fall asleep in their carriers, in the car, or in a pram, and will sleep just about anywhere – in a restaurant, at the cinema, at a friend or family member’s house. His ability to sleep well “on the go” will change significantly at 4 months, when he’ll need to begin getting better quality sleep in a quiet, darker environment.

2 Months Old:

You might notice your baby starts to have three or four roughly consistent times of the day when she’ll reliably crash out. If you follow her lead and give her the chance to nap uninterrupted at these times, this should eventually turn into a couple of decent and consistent naps (roughly a couple of hours each).

Your baby’s nighttime sleep averages about 9 (broken) hours, with around an additional 5 (broken) hours of naps through the day (Holland 2004; West 2010).

Your baby’s brain will take longer to sort out daytime sleep, so napping will remain fairly disorganized this month – and probably until she’s about four months (West 2010). She will take three or four naps.

Towards the end of this month, at around twelve weeks, the morning nap should start to fall into place, lasting about one to one and a half hours and occurring around the same time each day (West 2010).

Around this time, your baby’s internal circadian clock starts to develop (circadian is Latin for ‘around a day’). It is situated in an area of the brain known as the hypothalamus. Her circadian clock is regulated by internal factors like hunger and tiredness, as well as external ones, such as light and dark, and his day-to-day schedule. She will probably have more periods during the day when she’s showing an interest in her surroundings. At night, she may be sleeping for longer stretches, typically up to four hours at a time, sometimes longer towards the end of the second month (Grace 2010; West 2010). This is known as a ‘diurnal’ sleep pattern. Some babies can sleep for up to eight hours at a time but this is pretty unusual.

For the majority of babies, one or more night wakings will still be a feature in this second month (Smith 2007).

There are no bad habits at this age; your baby legitimately needs your help, so feel free to rock, feed, bounce, or walk her to sleep.

From this age, or sometimes before, your baby may start to make ‘snoring’ noises in her sleep. These are caused by loose mucus in the nose and throat (common in young babies) and may be accompanied by a rattling in her chest, which you may be able to feel with your hand. You may also notice a pause in your baby’s breathing for a short period. Some babies have more of a throat gurgle, usually the result of having a sort and flexible airway. This resolves itself within a year or two as the rings of cartilage in the airway become more rigid. These snoring sounds do not usually interfere with your baby’s breathing and will disappear over the next few weeks. Always have any breathing irregularities, snores, gurgles or pauses in your baby’s breathing checked by your doctor. Although it is unlikely to be a serious problem.

If you have chosen to get your baby vaccinated, she will have her first set around now. Vaccinations can interfere with your baby’s sleep for a night or two (West 2010).

Another growth spurt, hang in there. If you’re BFing, take comfort in the knowledge that nursing triggers hormones that will help you and your baby resume sleep after each feed.

After the growth spurt you are likely to find that your baby has a period where he sleeps longer. He may even add an extra nap or two to his usual quota (Lampl 2011).

Your baby is now less portable for day sleep. He will tend to need a quiet and familiar environment without a lot of light, noise, and distractions.

Your baby will need about 14 to 15 hours of sleep per 24 hours but now much more of this is night sleeping (about 11 hours), with about three and a half hours of daytime naps.

Production of melatonin, a hormone that promotes sleep by relaxing our muscles and making us drowsy, begins around now (West 2010).

Lots of parents find that three months is a bit of a turning point, in particular because your baby’s body clock is regulating, he’ll be able to take bigger feeds, and will naturally be able to go for longer stretches in between. However one or two night wakings is still normal.

Up until now your baby has experienced a phase of REM sleep at the beginning of each sleep cycle. However now that he has matured a little, this initial REM sleep phase is replaced by NREM (deeper) sleep.

Some researchers believe at this age your baby should be confident sleeping without your nighttime assistance for more than just an hour or two (Smith 2009).

Your baby’s naps are becoming a little bit longer and there are blocks of time around the clock where sleep happens regularly.

If you feel ready, you can start working on putting your baby down drowsy but awake for his nap, although at this early age he may need to be a little higher on the ‘drowsy’ end of that scale.

At this age, after two hours of being awake, your baby will start showing sleepy signs. He may: decrease his level of activity and go quiet; lose interest in people or toys; start yawning; rub his eyes; look ‘glazed’; become fuzzy or irritable; bury his head in your chest or turn away from you.

By now, you can probably get away without changing your baby’s diaper at night, as his skin no longer has a newborn’s vulnerability.

Between now and 6 months, most babies will begin to sleep through the night (defined as five consecutive hours) (Friedman and Saunders 2007; Pantley 2009). The usual scenario is that they drop a feed between 12am and dawn so they sleep through from an hour or so before midnight to six or so in the morning. Be aware that your baby might do this once and then not again for days. The first sleep through is often a big surprise to parents, especially the breastfeeding mother who will have exploding melons. About half of babies start ‘sleeping through’ at this age (Green 2002).

Your baby still has short sleep cycles (50 to 60 minutes), which means that even if they begin to ‘sleep through’, they may still stir, but are able to soothe themselves and put themselves back to sleep.

Your baby’s risk of SIDS reaches a peak at this age, so it is more important than ever to continue following good practice guidelines (found here).

Despite what you may hear from well-meaning friends that you should get your child into a sleep schedule, follow your child’s lead, and allow him to sleep when he wants to sleep and feed when he wants to feed. At this age, your baby’s biological and neurological systems are still too underdeveloped to embrace a schedule.

At three months of age, 46% of babies are still waking their parents regularly through the night (Scher 1991).

4 Months Old:

By now, most babies will sleep 12-14 hours out of 24 and for twice as long at night (8-10 hours) as during the day, although this will not be unbroken if your baby is still waking for feeds (Laurent 2009; Welford 1990).

The proportion of your baby's nighttime sleep has increased from 55.8% at Day 2 to 64.3% now at 4 months (Huang et al 2009).

Your baby will have a relatively peaceful block at the beginning of the night, but from the early hours onwards, sleep becomes much lighter and more fragile overall (Grace 2010).

Some studies suggest that the longest stretch of unbroken sleep your baby is capable of at this age is 6.8 hours (Huang et al 2009).

Ideally, your baby should aim to nap for ninety minutes or longer, morning and afternoon. A third late-afternoon nap can be shorter. She may well stir after ten minutes, and again after twenty to thirty minutes, predictable times for a partial awakening from a nap at this age (West 2010).

If your baby has begun waking when previously she slept through, it’s not necessarily a sign that she’s hungry and ready for solids, as many people believe, but more likely to be due to changing sleep patterns, which occur around now (Smith 2009).

By 4 months, your baby has entered a significant cognitive milestone; her brain is going through an enormous growth spurt, which accounts for all of the increased alertness and distractibility. Consequently, she may start waking at night or taking short naps – even if she was previously a great sleeper.

Some paediatricians maintain that, “children older than 4 months have the ability to soothe themselves into sleep consistently, to learn how to fall and stay asleep, and to remember these skills from one night to the next” (Waldburger and Spivack 2009).

Your baby is now transitioning out of the “fourth trimester”. This means that her sleep and feeding patterns are more strongly regulating. Over the fourth and fifth months, melatonin secretion rises and non-REM sleep increases, meaning your baby sleeps more deeply than she did as a newborn. But the non-REM also means that each time she has a partial arousal, it’s more distinct, and she feels more awake (Coons and Guilleminault 2008; West 2010).

Your baby is likely to have outgrown her moses basket, if you have been using one. However she might be weary of the large openness of his cot, which must seem huge compared to the moses basket. Hint: for the first few nights, put her in the moses basket inside the cot until she gets used to being in the cot.

Your baby is in the process of learning to roll over and will temporarily start waking up at night to practice this new skill. Unfortunately there will be a period before she learns how to roll back again, meaning that you may be summoned several times a night to reposition her when she has got stuck in an awkward position. Luckily this developmental phase rarely lasts for more than a week or two.

Your baby cannot ‘sleep through’ without a feed until they are at least 5 months old and 15 pounds in weight (Waldburger and Spivack 2009). However some sources suggest that your baby is unlikely to need more than one night feed at 4 months (although she may want them), unless she was born prematurely and your doctor advises it (Laurent 2009).

If you are returning to work around now, don’t even contemplate any sleep training. Your separation from your child is going to be an adjustment all by itself.

If you’ve been swaddling, it would be best to stop now. Although it can be a wonderful tool for helping babies to sleep up until this age, it ceases to work well as babies become increasingly mobile. In addition, babies 4 months and older tend to burst out of the swaddle in the middle of the night, which means it also becomes a safety hazard.

When your baby was a newborn, deciding when to put her down for the night was as easy as watching for the signs of sleepiness she gave such as crying, yawning or rubbing her eyes. While your baby may still do these things (and you should still respond to them), you don’t need to wait for these signs before you put her to bed. You can now take more control of bedtimes, by putting her down at roughly the same time every night, with a similar routine. She will probably respond well to routine at this stage, and enjoy the rituals of preparing for her night-time sleep.

5 Months Old:

Your baby needs to sleep 3-4 hours during the day usually in three naps: a morning nap, an early afternoon nap, and a short nap before dinner (Friedman and Saunders 2007). Each nap will be around an hour in length, and their timing will be more predictable than before.

Some sources suggest that for a five-month-old baby, staying awake for 3-4 hours before going to sleep through the night is ideal (Skula 2012).

Play and interact with your baby when he’s awake and active between naps. At five months, he'll generally be able to stay awake for around three hours at a stretch.

Several studies suggest that your five-month-old will need a nap two hours after they wake in the morning; then again 3 hours after their first nap; and once again 2 hours after their second nap. These are your 5 month old’s optimal “sleep windows” in which it is easiest to drift off to sleep. The theory is, if your baby goes too far past this window – in other words, goes to bed too late for his age – his body becomes stressed and produces too much cortisol. This hormone acts as a stimulant, like adrenaline or caffeine; cortisol can cause your child to act ‘wired’ or appear to get a second wind, even when he’s overtired. Elevated levels of cortisol in your baby’s system have three possible effects: he’ll have trouble settling to sleep; he’ll wake more frequently throughout the night; or he’ll wake up to early in the morning (Waldburger and Spivack 2009; West 2010).

Each of your baby’s naps should last at least 1 hour. Why is the length important? Naps less than 1 hour are not considered restorative and do not significantly lower levels of cortisol.

Some sources suggest that your baby is now old enough for a sleep schedule and/or night weaning if this is what you wish to do (Waldburger and Spivack 2009).

If your baby is still feeding through the night, he is legitimately feeding out of habit – in other words, he’s used to eating something – and is taking part of his 24 hours milk requirement at night rather than during the day. If you wish, it is now possible for you to transfer your nighttime feeds to daytime feeds (not eliminate them) through a gradual process. When doing this, you may notice that he nurses more frequently through the day or nurses for a bit longer at each feed.

At this age your baby will begin having shorter REM periods of sleep and longer non-REM (Sears 2009). This means that he will sleep more deeply for longer than he did before.

6 Months Old:

By now, your baby’s world is an endless source of fascination, and she will be wide awake and alert during play periods. Whilst she’s more likely to sleep well after these interludes of intense activity, she may be less willing to cooperate at naptimes or bedtime – after all, there are so many interesting things to do.

Your baby’s brain no longer simply ‘shuts down’ when she’s tired, so she’s now able to stay awake at will, even when she needs sleep (Holland 2004).

According to some sources, your baby is now physically capable of sleeping for up to 12 hours at night uninterrupted and without milk (Cave and Fertleman 2012). However...

The average 6 month old still wakes two times a night (Cooke 2009) for an average of 23 minutes each time (Teng et al 2012). Some 39% of 6 month old babies still wake 'regularly' (Scher 1991). Only 16% of babies 'sleep through' at this age (Emmett 2001).

Your baby will usually nap two to three times a day and then sleep for 10 to 12 hours at night, though not always continuously. The most important factor in how many naps your baby needs through the day is her ability to stay awake – particularly in the morning after a night’s sleep. A baby who can stay awake for 1-1.5 hours every morning needs three naps. A baby who can stay awake for 2-2.5 hours in the morning will start to nap just twice.

If your baby is only napping twice, the lunchtime nap will be longer, between 2 and 3 hours long (Cave and Fertleman 2012).

At this age your baby will experience another growth spurt. Once the spurt has passed you may find that your baby drops one of her night feeds altogether. This is because her sleep-wake cycles are becoming less dependent on hunger: as her stomach capacity grows, she can go longer without needing to feed.

Your baby will likely be teething in earnest at the moment. The average age for a baby to cut her first tooth is around 6 months (Grace 2010). However whilst teething can interfere with sleep, it does so far less than many parents anticipate or believe. To ascertain how much sleep disruption stems from your baby’s teeth, compare day with night behaviour. If she’s her usual self all day but extra cranky or difficult at night, it is probably not teething causing it.

The risk of SIDS is reduced significantly by 6 months, likely related in part to a baby’s ability to roll herself over and lift her head effectively and also to the fact that she is more neurologically mature.

The Foundation for the Study of Infant Deaths recommends that your baby shares your bedroom for the first six months, so she can now be moved to her own bedroom if you wish.

Your baby now has a growing sense of being an individual, and may wake up and miss you in the night.

Now that your baby has started solids, you may want to introduce so-called ‘sleep training’ (think Gina Ford), although it is unnecessary. If you’ve kept your baby in your room with you for the recommended six months and have decided to move her into her own room, allow her whatever time she needs to get used to this arrangement before starting any kind of sleep training. Bear in mind that most sleep therapists recommend that you wait until your baby is 12 months old before you attempt any sleep training which involves leaving your baby to cry (Hames 1999).

Your baby should neither go to bed hungry nor with too full a tummy. If your baby has started eating solid food, she should have this meal at least an hour or two before going to sleep at night.

When introducing new foods, it is best to offer them in the middle of the day so that you can see whether she tolerates that particular type of food. Then, if she gets an upset stomach, it will happen during the day and not the night.

Any significant change to your baby’s daily routine may lead to a period of increased waking during the night. One significant change that could happen around now is your return to work. As well as missing you, your baby will be coping with a new childcare arrangement.

Your baby is in the process of learning to sit up unaided and will temporarily start waking up at night to practice this new skill.

7 Months Old:

It’s pretty exhausting being a baby. At seven months, your little one still needs 12 to 14 hours of sleep per 24 hours to aid the maturing of his growing brain and body, so a couple of daytime sleeps are still necessary to make up the full quota.

Around now your baby will transition from three to two naps. You will find that your baby begins to shorten one of his three naps, in preparation for giving it up altogether.

Once your baby has given up one of his naps, it’s a tough time. Three naps seem like too many but two naps don’t seem like enough. You may find that your baby seems cranky around the time that he used to nap. You could try moving his lunch forward a little so that he has his afternoon sleep a bit earlier. It’s also a good idea to establish a quiet period around the time he used to nap, maybe reading a story to him or listening to music.

On some days he may still need a very short third ‘blip’ nap (often in the car or stroller), and on other days two longer naps will seem sufficient.

Some sources maintain that at this age, a *short* period of crying prior to falling asleep is normal and not harmful (Friedman and Saunders 2007). It can be your baby’s way of settling down.

Some connection between sleeping and eating remains, but the link is not as strong as it was. By now, a bigger stomach and a daytime diet that includes solids mean that most healthy babies do not need to feed at night (Friedman and Saunders 2007; Smith 2009; Welford 1990; Holland 2004), although they may do so as a source of comfort. “If he is waking at the same time every night, that’s a pretty good indication that it’s habit” (Smith 2009).

After an hour or two of sleep, you may hear your baby fuss. This awakening is likely to be a sleep arousal, an event that occurs every 60 minutes or so during sleep. Allow your baby the opportunity to put himself back to sleep before going in to check on him.

Around now your baby will begin to experience what is known as ‘separation anxiety’. He may suddenly become difficult to settle and get upset when you leave him to go to sleep. Bedtime and night-time awaking may suddenly become complicated by problems that up till now hadn’t bothered him. He may also be uncharacteristically frightened by loud noises or changes to routine, and he may start to wake at night and cry for you. This is a normal and temporary phase. A ‘transitional’ object may help him now (e.g. comforter).

Don’t be alarmed if you see your baby start to adopt strange sleeping positions, even curled up on his stomach with butt in the air and head to one side. If your baby can roll onto his stomach to sleep he should be able to roll back if he wants to: the stomach position is more of a worry for younger babies who can’t move themselves. This new mobility is a sign of your needing to worry less – not more!

8 Months Old:

You may find another disruption in your baby’s sleeping patterns around now. This is a time when your baby will hit many developmental milestones (sitting unaided, pulling up, shuffling, perhaps even crawling). Reaching a developmental milestone is like winning the lottery for your child; she’ll be so revved up with excitement and wanting to practice her new skills that she won’t feel much like sleeping. For this reason, don’t attempt any form of sleep training if your baby has reached a developmental milestone in the last seven to ten days.

A common consequence of hitting important developmental milestones is very early waking – the pre-six o’clock syndrome. However it is usually short-lived as your baby becomes accustomed to her new skills. You can optimistically expect it to last only a couple of weeks. If early waking lasts longer than this, it is worth checking to see whether a regular early-morning noise could be waking your baby up, such as a train passing, the build-up of traffic if you live near a busy road, or simply the dawn chorus of birds. Try moving your baby’s sleeping place away from the window, out of earshot.

Between 60-70% of 8 month olds are able to fall back asleep without parental assistance, although not consistently (Porter 2007).

Bad news: around 40% of babies with a 'sleep problem' at this age will continue to have a sleep problem until at least 3 years of age, ouch! There's also a 20% chance that a baby who sleeps well at 8 months may develop a sleep problem at age 3 (Zuckerman et al 1987).

By now babies have generally settled into a regular pattern of two naps per day, one in the morning and one in the afternoon. You will probably find that your baby is sleeping a little longer at night once he has started taking just two daytime naps.

Your baby will need to sleep 2 to 3 hours total during the day.

The optimal ‘sleep windows’ for a eight-month-old suggest that your baby will need a nap 2 hours after waking in the morning; then again 3 hours after they wake from their first nap (Waldburger and Spivack 2009).

Your baby needs about 14 hours of sleep per 24 hours. Nighttime sleeping will total about 11 hours (71.2% of all sleep) and may no longer be broken up with any feeds except during phases when your baby is teething and needs comforting, or your baby is going through a growth spurt (Huang et al 2009).

Some babies tend to wake at sunrise, raring to start their day. If your baby consistently wakes up at this time, consider whether she needs a slightly later bedtime or shorter daytime naps – she is unlikely to sleep 12 hours at night at nine months if she has had a couple of three-hour sleeps through the day.

It’s quite common at this age for babies who had been sleeping through for some time to start a phase of night waking again, with 58% waking regularly (Scher 1991). This change occurs at about the same time that babies discover a toy or other object that disappears under a cloth actually still exists. Psychologists call this intellectual breakthrough ‘object permanence’. From your baby’s point of view, it means that out of sight is no longer out of mind. The same thing happens in the middle of the night: when your baby wakes up and finds herself alone, she now knows that you are nearby even if out of sight, so she cries for company.

Your baby may now find it harder to drop back to sleep without you to help her. She may have become very attached to a particular method of going to sleep, whether that involves sucking a pacifier, holding a toy, or being cuddled by you, so she then needs this again when she wakes at night.

10 Months Old:

Around this age your baby’s sleep patterns become very regular, so that he wakes up and goes to sleep at around the same time every day, and his sleep spans are longer (Holland 2004).

Your ten month old will need around 13 to 15 hours total sleep in a 24 hour period.

The optimal ‘sleep windows’ for a ten-month-old suggest that your baby will need a nap 3 hours after waking in the morning; then again 3-4 hours after they wake from their first nap. One of these naps, often the morning one, will be longer (Johnson 2005).

Your baby’s increased mobility may mean it takes longer to get him to lie down and go to sleep in his cot. This is the age when many babies first discover they can stand by pulling themselves up with the help of the bars on their cots.

For some babies of this age, periods of REM sleep (dream sleep) can be a noisy affair: your baby may cry, laugh, talk roll over on to all sides, and practice everything she knows how to do, and yet still be more asleep than she is awake. Try not to interfere with this natural aspect of sleep too quickly. Wait for a moment (for example, by counting to ten) before intervening and comforting her. It is likely that your baby will fall back into deep sleep herself.

11 Months Old:

At this age, your baby is likely to be steady on two naps per day. What may happen, however, is that she begins to resist either her morning or afternoon nap, which may lead you to think that it’s time to transition to one day a day. Not quite! Almost all children make this shift after their first birthday, but those who attempt to nap only once a day too young quickly become exhausted (and have terrible night waking due to being overtired). A child who begins to protest her two-nap schedule is, however, able to stay awake longer during the day, in slow but steady increments.

About one in five 11 month olds is still waking at least once during the night (Ashworth 2004 et al).

At the moment your baby is all about movement. She’s crawling, probably pulling to a stand and cruising, perhaps even walking. As your baby continues to be able to move her body more and more efficiently away from you, particularly once she begins crawling or walking (or even thinking about doing so), separation anxiety reaches a fever pitch. Sleep (unless you’re cosleeping) is yet a form of separation, so you may begin to see some serious protesting around going down for a nap or even for bedtime at night. You may find your baby suddenly starts taking very short naps, as they loathe being apart from you (Porter 2007).

Now would be a good time to remove your cot bumpers (so she won’t use them to help her climb out), and put the mattress on the lowest possible setting. For safety, be sure you’ve removed all other toys or objects she could stand on.

If your baby is resisting her naps, she is likely to be overtired by the time she goes to bed at night. Consequently, her body will produce the stress hormone cortisol, which can cause her sleep to be choppier and more fragmented throughout the night and can trigger early-morning waking as well.

12 Months Old:

Happy birthday baby! The average parent has lost a whopping two months of sleep by their baby’s first birthday (Smith 2010; Think Baby 2007).

At this age, your baby will need to sleep around 12-14 hours in 24 (Laurent 2009).

Beginning now, most babies will nap for a total of 2-3 hours during the day. This usually consists of two naps - one in the morning, and one in the early afternoon.

At this age, most babies sleep through the night, but may awaken early for a breast or bottle fed, then return to sleep for an hour or two (Spock 2004).

Your baby can now have a low-tog, cot-sized duvet and pillow, but keep a careful eye in case he learns to use it as a step to help him climb out of the cot (if you’re not cosleeping, that is). Adjustable cot bases should be at the lowest position now to foil your intrepid explorer and any toys large enough to be used as steps should be removed from his cot.

Your baby is physically capable of taking in all the calories and hydration that he needs during the day rather than at night (exceptions: when your child is sick, if he has allergies that cause him to cough, or if he is taking medication that can increase thirst, he may need additional hydration at night).

You may notice that your toddler takes longer to fall asleep now and sits in his cot babbling away.

16 Months Old:

The optimal ‘sleep windows’ for a sixteenth-month-old suggest that your toddler will need a nap 3-4 hours after waking in the morning; then again 3-4 hours after they wake from their first nap (Waldburger and Spivack 2009).

Around now your toddler will transition from two daytime naps to one nap. This is a gradual process. One some days, your toddler will may still need a second ‘blip’ nap, and on other days one nap will suffice. To get by on one nap, your toddler needs to be able to stay awake for four hours after she wakes up in the morning and for six to seven hours before going to bed for the night.

When your toddler starts taking just one nap, her night-time sleep with usually lengthen by 30 or 40 minutes; often you will notice that her night-time sleep shortens a little in the weeks before this happens.

The morning nap is likely to be the one your child gives up, however you don’t want to rush the process if your child is still benefiting from this important sleep time. Morning naps have more dreaming, or REM sleep, which is what makes them so important to infants and young babies, who require more REM sleep than older babies and toddlers because of the type of brain development that occurs in the early months.

Your toddler’s only remaining nap is likely to happen after lunch, in the early afternoon, and last between 2 and 3 hours.

17 Months Old:

Many toddlers of this age feel more secure when their daily life is familiar and expected. Some paediatricians claim that you are more likely to get an uninterrupted night’s sleep if your toddler is used to being put to bed at a regular time (Laurent 2009).

At this age, your toddler can’t stop moving and doing, but ironically, he needs his sleep more than ever; approximately 13 to 15 hours in a 24-hour period to be precise. The best way to tell where your child falls in this range is to watch his energy level, mood, and behaviour. If he wakes in the morning after 10 hours seeming tired or has a hard time making it to nap time, he’s not getting quite enough night sleep.

Don’t be surprised if bed comes top of the list of places your toddler would least like to be. Bedtime involves relinquishing toys, family and fun – so your efforts to put her down for the night may be met with considerable protest.

The most common ‘sleep problem’ for a child of this age is early waking (Grace 2010). Your toddler is all too aware of the delights of the coming day.

After 18 months, your toddler may be able to stay awake a bit longer at night, perhaps until 8pm. Don’t change their bedtime, though, unless your child is having trouble settling to sleep. If she’s still going down at 7.30 and sleeping just fine, then you have the right bedtime!

Some sources maintain that your baby should now be able to go twelve, even fourteen, hours from dinner until breakfast, without a bedtime snack except perhaps a glass of water (West 2010).

20 Months Old:

The optimal ‘sleep window’ for a twenty-month-old suggests that your toddler will need their one and only nap in the early afternoon after lunch (around 2pm) 5-6 hours after waking in the morning. This will take advantage of your child’s natural dip in energy and biological rhythm. The nap will usually last 2-3 hours (Waldburger and Spivack 2009; Margo 2010).

Some sources indicate that the best time for your toddler to go to bed for the night at this age, is around 7pm, and the best time for getting up is between 6.30 and 8am (McLaughlin 2009).

The optimal ‘sleep windows’ for a 2-3 year old suggest that your toddler will need their nap 6-7 hours after waking in the morning (Waldburger and Spivack 2009).

Around now your child’s second molars will be pushing through his gums. These large, flat teeth can take a bit of time coming through and can cause a lot more discomfort than any of his prior teeth. Sucking on the breast or pacifier may be painful as it can make your child’s gums hurt. So if your toddler uses this as a way to get to sleep, he may find it difficult for a few days.

Bedtime tantrums may peak around now. If your child is regularly having tantrums at bedtime it may be because he is generally overtired. If this seems the case check that he’s getting enough sleep during the day – especially in the early afternoon.

By their child’s second birthday, most parents have missed out on the equivalent of 6 months of sleep (Think Baby 2010).

43% of toddlers require longer than 30 minutes to fall asleep at this age (Green 2006).

52% of toddlers are still waking during the night at this age (Green 2006).

After all those sleepless nights it may seem almost impossible to believe it, but by this age your toddler has spent more of his life asleep than awake (McLaughlin 2009).

Now that your toddler has left his babyhood behind him, you may be considering transitioning him from his cot (or cosleeping arrangement) to a ‘big bed’. However I do not recommend doing this until age 3. It’s usually better to keep your toddler in his cot, which allows him to feel safely contained. This way, he can feel confident in his ability to take giant emotional and developmental leaps during the day but still regress to the coziness and security of his good old cot at night. “Children who switch too young to a bed may experience sleep disruption and difficult bedtimes with tears and tantrums” (West 2010). However if your child has shown lots of interest in sleeping in a bed or has climbed out of his cot frequently, it may be time to make the change. A good rule of thumb is that toddlers who are 91cm (3ft) tall will need a ‘big’ bed – they are tall enough to vault out of their cots.

If your toddler is still using a sleeping bag, you may find that he is able to undo the zips and poppers himself and climb out of the bag during the night and then be unable to get back in. This can interfere with sleep when he gets too cold. (Hint: turn the sleeping bag back to front so that the zip is out of reach).

30 Months Old:

If you have yet to move your child into a big bed (I suggest waiting until her third birthday), it can be useful to set up the bed in her room around now, so that she gets used to seeing it and practising lying in it. It also gives your child the feeling of having a ‘choice’ between the two.

Your toddler will probably spend around 11-12 hours asleep at night.

As your toddler has now built up a rich vocabulary, they may begin to talk about their dreams.

At this age, aiming for about an hour of moderate exercise each day, will help your child fall asleep more easily at night and stay asleep. This could be a run around the garden, a trip to the park, or a walk to the local shops.

Chances are that your toddler doesn’t go straight to sleep when you put her in her cot/bed. In fact, forty percent of 30 month olds take 30 minutes of more to fall asleep. This is the most common scenario, followed by thirty percent taking 20-30 minutes, twenty percent taking 10-20 minutes, and ten percent taking less than 10 minutes (Nicholls 2009).

At this age, your toddler “may start to enjoy her afternoon nap and perhaps even ask to be put to bed sometimes” (Cave and Fertleman 2012).

3-5 Years Old:

It is estimated that about 25 percent of children this age snore at least sometimes and about 12 percent snore often (Margo 2010).

Your child is likely to have moved from cot to bed now. Initially, he may find this a difficult transition to make. He may be anxious, finding it difficult to settle and waking during the night. Make the transition fun by letting him chose some new bedding and maybe a new cuddly toy. Also, for the first few weeks, he may fall out of bed. To prevent this, you can buy a bed guard that fixes on to the side of the bed.

As a result of the transition from crib to bed, you may have a little ‘night visitor’ arriving at your bedside at all hours. 28 percent of preschoolers change their sleep location during the night (National Sleep Foundation 2004).

Good news: Your child is starting to develop some self-regulation skills, meaning that he can listen to instructions, stop his body from doing the first impulsive thing he feels, and sit quietly for short periods. By the way, these are exactly the skills that will come in handy when you ask your child to stay in his bed at night (if not cosleeping).

Bad news: With an onslaught of language development and an increase in cognitive abilities, your child can finally ask for things. “One more story”, “One more cup of juice”, and other such requests can become effective tactics to stall bedtime for even the most steadfast parents. Although children this age typically still want to please their parents, they also want increasing independence and learn that they can manipulate to get what they want.

Half of parents with a child this age have to be present in the room while their child falls asleep (Margo 2010).

It should take your child about 20 minutes to go to sleep (Margo 2010). However...

At this age, your child is very good at keeping himself awake, even when he is feeling exhausted. If your child is often irritable during the day, the chances are that he’s tired because he’s not getting enough sleep at night. Inadequate sleep is also often linked with aggressive or impulsive behaviour, ‘hyperactivity’ and inattentiveness. Your child might become so fragile that any small discomfort or frustration will make him start to cry inconsolably.

Your child still needs approximately 11 to 14 hours sleep in a 24-hour period.

Your child’s sleep cycles have increased from 40-60 minutes (when he was a baby) to about 90 minutes and will stay this length for the rest of his life (Skula 2012).

By the age of three your child now spends approximately 33 percent of his sleep in REM sleep (Margo 2010).

Most children start to give up their daytime nap between the ages of 3 and 4 years. However 25 per cent of children continue to nap at the age of five years (Holland 2004). Recent research suggests that a midday nap can help your preschooler to learn (The Guardian 2013).

If your child begins to regularly play during nap time and not sleep. Your child's one nap might be on its way out. Giving up their nap is a gradual process, sometimes lasting a year (Pantley 2009). You may find that the nap gets shorter and shorter over time until it is eventually dropped. It's important to see a pattern with this when you finally decide to end napping on a regular basis. If one day your child doesn't nap but does the next day, you might consider still giving him the opportunity to nap until he regularly doesn't take the nap. At this point, keep the nap in your back pocket so to speak, he might need one occasionally.

If your child has given up their nap, you may find that they still fall sleep in the car or stroller during the day.

Even if your child doesn’t want to sleep at nap time, he still needs to rest. Try to make a routine out of nap time whether your child sleeps or not by, say, playing some soft music or reading a gentle story. This will help to lower his cortisol levels somewhat. It can be useful to give your child some idea of how long nap time will be; one way of doing this is to put on his favourite CD and say that nap time isn’t over until the CD is finished.

If your child has given up their nap, they may start waking up in the middle of the night. This is normal. At the beginning, your child is still a little bit overtired from this new "no napping" lifestyle.

If your child is still napping, the optimal ‘sleep windows’ for a 3-5 year-old suggest that your child will desire their nap 7-8 hours after waking in the morning (Waldburger and Spivack 2009).

Some children will push their nap later in the day (say to 2pm), and some drop their nap altogether. Once your child has given up his nap altogether, his nightime need for sleep generally increases by an hour or so.

Your child is going through many developmental changes, and these may affect his sleeping patterns in new ways. Major transitions at this age include the arrival of a new sibling, potty training, starting preschool, and transitioning to a bed. Unresolved feelings about all of these issues can lead to separation anxiety and can cause fears at bedtime, protesting behaviour, and night waking. Whenever possible, avoid allowing your child to take on more than one of these big changes at a time (Mulholland 2009).

Your child may have been a good sleeper but has started waking up in the night and finding it difficult to settle to sleep again. This is quite common as a child gets older. He is taking in more and more information and sometimes his little brain doesn't seem to be able to switch off. He may also be having vivid dreams.

If your child has a late afternoon nap at preschool, this may make it difficult for him to settle in the evening.

One of the best things you can do to help your child to feel secure and to sleep well is to stick to his regular bedtime routine. Not only will this be a source of reassurance and stability in his changing world, but it will also play a crucial role in helping him to unwind after all the excitement and activity of a typical preschooler’s day.

You may find that your child starts needing more sleep as he grows rather than less. For example, children starting preschool often seem to become more tired because of the social and educational demands made on them. Watch out for signs of increased tiredness, which may include cross and irritable behaviour in the mornings and in the evenings.

Your child is unlikely to be consistently dry through the night. Although the average age for completing daytime potty training ranges from 28 to 36 months, nighttime training very often comes much later – even years later! Children’s brains have an easier time recognising when their bladder needs to empty itself during the day than they do at night. It is normal for a child not to complete potty training until 5 or 6 years old (Waldburger and Spivack 2009). Most doctors won’t consider giving any form of therapy to children who wet the bed under the age of 7 because so many grow out of the tendency by themselves by this age (Welford 1990).

69% of four year olds require more than 30 minutes to fall asleep (Green 2006).

Somewhere between a fifth and a third of all families say they have a sleeping problem during the preschool years (Hames 1998)

If you have never succeeded in establishing a regular bedtime, it’s not too late to introduce one. The added bonus with a child of this age is that you can explain in words what you want him to do, and he can understand and remember much more readily.

Between the ages of 3 and 5 children quite often have bad dreams and night terrors. This is normal because while his understanding of the world is growing, he can’t entirely make sense of it, and so he goes to sleep with unresolved questions.

By this stage, most children’s sleep patterns become like those of adults (Sears 2009).

By four years old your child can comfortably stay awake 6-12 hours between sleep periods (Pantley 2009).

Starting school may make your child tired and grumpy - not only because she has to concentrate all day, and probably be on her best behaviour, but also because she is growing and developing, and together these factors create a drain on energy levels.

Some children of this age begin sleepwalking. If your child has started to do this, make sure he is safe and can't fall out of a window or down the stairs. For more information on sleepwalking, see my Timeline of Challenging Early Childhood Behaviour.